Results of treatment of patients with maxillary sinus carcinoma

Abstract

BACKGROUND Information regarding results of treatment and possible prognostic factors in patients with maxillary sinus carcinoma is limited. METHODS Between 1969‐1995, 48 consecutive patients presented to the study department for curative treatment of maxillary sinus carcinoma. Tumor classification according to the American Joint Committee on Cancer staging system was T1 in 1 patient, T2 in 6 patients, T3 in 17 patients, and T4 in 24 patients. The N classification was NO in 43 patients, N2a in 1 patient, N2b in 3 patients, and N2c in 1 patient. Treatment to the primary site was comprised of surgery (Sx) and radiation therapy (RT) in 37 patients and RT alone in 11 patients. RESULTS There was a difference in disease free survival between patients who underwent Sx + RT compared with patients who received RT alone; combined therapy results were more favorable. The most common pattern of recurrence was in the primary site, which was found in 22 of 48 patients (45.8%). For patients who underwent Sx + RT, local control at 3 and 5 years was 65.2% and 59.2%, respectively; for patients who received RT alone, local control at both 3 and 5 years was 22.7%. There were 12 late complications found in 8 patients: fistula formation (5 patients), trismus (3 patients), osteonecrosis (1 patient), retinopathy (1 patient), cellulitis (1 patient), and nasal stenosis (1 patient). CONCLUSIONS The type of treatment to the primary site is an important determinant of disease free survival and local control. Failure at the primary site is the main problem in the curative treatment of patients with maxillary sinus carcinoma; efforts to improve survival in these patients should be directed toward improvement of local control. Cancer 1998;83:457‐465. © 1998 American Cancer Society.

Nasal and paranasal sinus carcinoma: Are we making progress?

“…The close relation between survival and local control underscores the fact that the prognosis for patients with nasal and paranasal sinus carcinoma is related directly to local control of the disease. 4,5,103,117,154,157,174,186,196 In the literature, global results, most often expressed in terms of crude survival, vary between 10% 60,61,63,70,77,80,82,152 and 75%, 40,106,109,132,135,160,161,165,176 with better results in carefully selected patients, in patients with primary tumors of the nasal cavity, and in more recently published articles. The average over- all survival rate from the systematic review analysis was 41%, and the overall survival rate for the 1990s was 51%.…”

Function preservation and optimal outcomes—definitive chemoradiotherapy with multi-phase treatment planning for locally advanced sinonasal cancer

“…Daly et al treated less than one quarter of patients with ENI and also found no nodal relapses [20]. However, Paulino et al and Hoppe et al found a 29 % regional relapse in patients not receiving ENI [13,16]. Le et al found a 12 % regional relapse in patients not receiving ENI, but no nodal relapse in patients receiving ENI [18] there is concern for added RT toxicity [16].…”

“…Due to the location of SNCs relative to critical structures, escalating dose to a therapeutic level while limiting treatment-related toxicities has posed a challenge. Prior to the 3D-CRT era, patients were treated with conventional two-dimensional RT (2D-RT) and the prescription dose was typically limited to a median dose of 60-68 Gy (range, 39 Gy-77.2 Gy) [5,8,[11][12][13]18]. LC rates were poor, and serious ophthalmic toxicity occurred in up to 69 % of patients [11].…”

“…Yet, in spite of advancements in technology, there has been no significant improvement in the 5-year OS rate since the 1960s. However, retrospective studies have shown reduced radiation-induced toxicity with the use of IMRT in the adjuvant setting and LC rates equal to or better than 3D-CRT [7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In this study, we present the results of 11 patients with SNC treated with definitive RT or CRT, using a two-phase IMRT technique.…”

“…Retrospective studies have shown surgery followed by postoperative RT has Electronic supplementary material The online version of this article (doi:10.1007/s13566-015-0226-3) contains supplementary material, which is available to authorized users. superior 5-year local control (LC) rates, ranging from 40 to 79 % [2,[5][6][7] compared with definitive RT or CRT ranging from 20 to 64 % [2,5,[8][9][10][11][12][13][14][15][16][17][18]. However, due to the proximity of SNCs to critical structures such as the brain, optic nerves, orbital contents, and carotid artery, surgery for very locally advanced SNC is often a difficult, if not unattainable, option [3].…”